March 2--Pintura Fresca

I had a nice day teaching today. I have pretty much finished ensuring that my students can complete their tasks safely and on time, and now I move into teaching them to think like nurses. How it works is that I will look at their patients's charts and make a few notes. Then I will come ask them to tell me about the patient. There are usually certain things I am looking for--can they connect the dots between seemingly random bits of information? Do they understand the implications of things?

I will gently question them, starting with straightforward stuff, and becoming gradually more complex. My goal is to take it to somewhere beyond where they are currently--the next level. I explain why I ask things, and what I see as the significance in the inquiry. I want them to know there is a reason for what I ask--I'm not just quizzing them for fun.

One of my students told me about his patient, who is in for a myocardial infarction. He informed me that the reason the patient was here was because he was "noncompliant" with his medication regimen. I asked him to explain noncompliance to me. He told me that it meant that a patient was supposed to do something but decided not to. In this case, the patient stopped taking his hypertension and diabetes medicines. I asked him if he had explored why the patient stopped taking his meds. He hadn't.

I knew why. I read back through the chart and found that the patient had lost his job three years ago, and with it his health insurance. He didn't have the money to buy his medications. That's why he stopped taking them. So we talked about avoiding terms like "noncompliance", about digging a little deeper to find causes for things, and about what he, as a nurse could do to advocate for the patient.

This is why I love teaching.

This fountain sits at the edge of the hospital campus. It is a quiet spot where I like to go sit in the morningwhen I am not grilling students. It was chilly this morning, but the sun felt good on my back, and the sound of the water was soothing.